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Increased risk of dementia following mild head injury for carriers but not for non-carriers of the APOE ε4 allele
Umeå University, Faculty of Social Sciences, Department of Psychology.
Department of Psychology, Stockholm University, Sweden.
Department of Molecular Genetics, Flanders Interuniversity Institute for Biotechnology, University of Antwerp, Belgium.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0002-8114-7615
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2007 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 19, no 1, 159-165 p.Article in journal (Refereed) Published
Abstract [en]

Background: The ε4 allele of apolipoprotein E (APOE) and head injury are risk factors for dementia diseases, and may act synergistically to further increase the risk. The aim of this study was to examine the association between mild head injury, APOE and dementia.

Methods: Data were obtained from the Betula prospective population-based study of aging, memory, and health. The study included 543 participants in the age range 40–85 years, free of dementia at baseline, who were followed up within a 5-year interval. Dementia was classified using DSM-IV criteria. Information on previous head injury was obtained through screening of the participants' answers to health questionnaires at baseline and at follow-up.

Results: Subjects with head injury but without APOE ε4 had no increased risk of dementia. Subjects with APOE ε4 had an increased risk and those with both APOE ε4 and head injury had the highest risk of dementia (odds ratio = 5.2).

Conclusions: APOE ε4 constitutes a risk factor for dementia, mild injury in isolation does not increase the risk, but head injury in combination with the APOE ε4 leads to increased risk of dementia.

Place, publisher, year, edition, pages
New York: Springer , 2007. Vol. 19, no 1, 159-165 p.
Keyword [en]
brain injury, apolipoprotein, Alzheimer´s disease
National Category
Research subject
URN: urn:nbn:se:umu:diva-7470DOI: 10.1017/S1041610206003498OAI: diva2:147141
Available from: 2008-01-14 Created: 2008-01-14 Last updated: 2015-12-14
In thesis
1. Mild head injury: Relation to cognition, dementia, fatigue & genetics
Open this publication in new window or tab >>Mild head injury: Relation to cognition, dementia, fatigue & genetics
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Following a mild head injury (MHI), a person may report a variety of symptoms such as headache, memory disturbance, dizziness, and concentration difficulties. For most persons the symptoms are transient, but some suffer persistent symptoms that can have a major impact on everyday life. It remains poorly understood why some but not others have full recovery after MHI. The aim of this thesis was to investigate outcomes after MHI, with particular focus on neuropsychological functioning, fatigue, and risk of dementia. A related objective was to examine the potential association of a genetic factor, Apolipoprotein (APOE), with MHI outcome. The APOE є4 allele has been associated with unfavorable outcomes after moderate or severe head injury, but little is known about its influence on outcome after MHI. In Study I and II, data from a population-based longitudinal study were used to compare neuropsychological functioning and fatigue before and after MHI. The results from Study I showed a post-injury decline in neuropsychological performance for є4-carriers, whereas the performance remained unchanged for non-carriers. Study II showed an increase in self-reported fatigue after MHI for both є4-carriers and non-carriers, with a more pronounced increase for є4-carriers. In Study III, a case-control study was conducted to examine whether a history of MHI increased the risk of developing dementia later in life. It was found that MHI alone did not increase the risk, but the combination of MHI and APOE є4 was associated with increased risk of dementia. Taken together, the studies generally indicate a positive outcome after MHI, but in combination with APOE є4 even mild head injury may lead to long-lasting negative outcomes. Consideration of pre-injury level of functioning and genetic factors seems critical for a complete understanding of the impact of MHI.

Place, publisher, year, edition, pages
Umeå: Psykologi, 2006
Neuropsychology, mild head injury, mild brain injury, apolipoprotein E
National Category
urn:nbn:se:umu:diva-852 (URN)91-7264-158-4 (ISBN)
Public defence
2006-09-15, Beteendevetarhuset, Bt 102, Umeå universitet, Umeå, 10:15 (English)
Available from: 2006-09-04 Created: 2006-09-04 Last updated: 2011-04-15Bibliographically approved

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Sundström, AnnaAdolfsson, RolfNyberg, Lars
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